Thousands in Hampton, Newport News eligible for expanded Medicaid

More than 9,000 residents of Newport News and 6,000 in Hampton would qualify for health coverage under the expanded Medicaid guidelines allowed by the Affordable Care Act, according to an analysis released this week by the Richmond-based nonprofit, The Commonwealth Institute. The Institute, which supports the ACA's expansion to 138 percent of the poverty level, included an interactive map with its report, "Mapping the Coverage Gap," showing the numbers eligible by city and county under the new federal guidelines.

"The takeaway is the sheer volume of individuals that would be eligible for coverage if lawmakers closed the coverage gap," said Massey Whorley, senior policy analyst. The "coverage gap" refers to those who make too much to qualify for existing Medicaid ($958 gross per month for one; $1,963 gross per month for a family of four) but not enough to purchase subsidized private insurance through the state's new ACA marketplace.

Reacting to critics of expansion who say people should "just get a job," Institute president and CEO Michael Cassidy said, "The majority are working and they're working in the most important sectors of the state's economy — tourism, retail and construction." He added that statewide more than 32,000 veterans have no health insurance and 12,300 would become eligible for coverage under expanded Medicaid.

Altogether, of the 177,000 uninsured in Hampton Roads, 38 percent, or 56,000, would gain coverage. The numbers are consistent with the rest of the state, according to Whorley, who used the 2011 U.S. Census — the most recent available — for his analysis. The percentages vary according to locality with 49 percent of Williamsburg's uninsured qualifying as compared to 30 percent in Poquoson.

The "Mapping the Coverage Gap" study showed the potential addition of 1,800 people to the rolls in James City County, along with 1,500 in York and 1,400 in Gloucester.

More than 1,147,000 Virginians are enrolled in Medicaid, a $6.7 billion government program; more than half of those are children living in low-income households, according to the Virginia Department of Medical Assistance Services. Currently, in Virginia, coverage is primarily available to children, pregnant women, the elderly, individuals with disabilities and parents meeting specific income thresholds. Expanded coverage would include one group — single adult males — that is currently ineligible.

Medicaid expansion is currently stalled in the Virginia General Assembly, with the Republicans calling for a two-year audit of the program. States that adopted the ACA expansion became eligible on Jan. 1, 2014, to tap into full federal funding of the additional recipients until 2016. After that, the states' responsibility will be phased in until it reaches 10 percent. For existing Medicaid, Virginia splits the costs 50-50 with the federal government.

If approved, the earliest that the expanded Medicaid program could now take effect in Virginia is July 1. To check your locality's numbers, go to http://www.thecommonwealthinstitute.org and "Mapping the Coverage Gap."

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